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| It is characterized by a sudden, severe, electric shock-like or stabbing pain typically felt on one side of the jaw or cheek. The trigeminal nerve is responsible for sending impulses of touch, pain, pressure and temperature to the brain from the face, jaw, gums, forehead and around the eyes. Some patients complain of sensation of burning or of having a fish-bone in the throat. Incidence The disorder is more common in women than in men and usually affects those over 50 although it does exist in many younger individuals including children. The attacks may come and go throughout the day and last for days, weeks or months at a time, and then disappear for months or years. In the initial stages, before the symptoms develop completely, TN is often confused with other diseases or dental problems. Some patients experience "atypical" trigeminal neuralgia, with more constant pain at a level generally of lower intensity. The rarity of these disturbances and the variability of these symptoms have caused some patients to undergo endodontic treatment of multiple root canals or other oral or sinus surgeries before a neurological disturbance is recognized. Diagnosis & Tests The diagnosis of trigeminal neuralgia may be made by obtaining a history of paroxysmal one-sided facial pain activated by several facial stimuli. A slight stimulation of the trigger point provokes pain. The relief of pain by carbamazepine gives more credit to the diagnosis of trigeminal neuralgia and treatment by a neurosurgeon. Treatment & Prevention Conventional treatment for TN typically includes anticonvulsant medications such as carbamazepine or phenytoin. Baclofen, clonazepam, gabapentin, and valproic acid may also be effective and may be used in combination to achieve pain relief. Prognosis The disorder is characterized by recurrences and remissions, and successive recurrences may incapacitate the patient. Due to the intensity of the pain, even the fear of an impending attack may prevent activity. Trigeminal neuralgia is not fatal. |
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